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Liver Transplant By A Living Donor - Understanding It In Detail!

Written and reviewed by
M. Ch.(HPB Surgery & Liver Transplant), FEBS, MBBS, MS - General Surgery
Liver Transplant Surgeon, Faridabad  •  19years experience
Liver Transplant By A Living Donor - Understanding It In Detail!

Living donor liver transplant is the procedure where a portion of the liver of a living donor is transplanted to one whose liver is damaged and beyond recovery. The source of graft liver can be from two sources namely from a deceased brain-dead donor or a Living-related donor and termed respectively as DDLT ( Deceased donor liver transplant) and LDLT ( Living Donor Liver Transplant) . 

In case of DDLT , the recipient name is registered in the NOTTO list , and whenever a suitable brain-dead donor is available the recipients are transplanted according to their position on NOTTO list. DDLT involves a longer waiting time before a deceased donor may become available which can be anywhere between a month to years . The recipient runs a risk of developing a fatal complications during the waiting period. In LDLT ( Living donor liver transplant) the graft liver is procured from a living donor who is related to recipient and agrees to donate a portion of his liver. After careful pre-operative evaluation of prospective donor nearly 60-70% of liver of donor is removed and transplanted into the recipient.

Due to the unique ability of human liver to regrow, within 6-12 weeks nearly 100% of previous liver volume is achieved. LDLT enjoys the benefits of a elective surgery done without any waiting time and delay. However both DDLT and LDLT have nearly 90% success rate and both the procedures have their own benefits and lacunaes. Also the decision to go for DDLT and LDLT may vary for any particular patient. 

Factor that makes living donors potent enough to donate part of their liver: 

  1. As the liver is composed of two lobes , right and left lobe. Also the liver has an unique ability to regenerate. 
  2. The donor’s right lobe preferably transplanted in and adult recipient and left lobe is transplanted in pediatric age group .. When the portion of the liver is in place in the recipient’s abdominal cavity, the transplanted liver generates supplementary liver tissue adequate for decent functioning. 
  3. The donor liver regrows to nearly 90% of its original volume in 6 weeks and nearly 100 % in three months. Morever liver functions tests revert to completely normal even before complete regeneration happens. 

The knowledge, essential for the living liver donors: 

  1. The living donor transplant method is a lifesaver, but there are some concerns. The donor should have an excellent health record and should be free from cancer, pulmonary hypertension, congestive heart failure, or any other chronic diseases. 
  2. The donor’s liver must be healthy and large enough so that it works correctly after the right lobe is removed. The operation may take many hours, and both the recipient and the donor must rest in the ICU overnight. 
  3. The donor can be discharged by the end of one week and can resume normal household and office work by end of second week.

Patient is advised to avoid abdominal straining for three months but after that he or she can resume absolutely normal life style. Living donor liver transplants have an advantage that they can be performed in elective setting when the patient and donor are well-optimized, eliminates the waiting time, donor liver has been well evaluated and can be performed quickly in advanced or decompensated patients. In case you have a concern or query you can always consult an expert & get answers to your questions!

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